(6 years ago)
Lords ChamberI am not familiar with the type of insurance the noble Lord is talking about, but would be delighted to see what he has been offered. The 2012 Act obliges income from non-NHS activities to be tied to a foundation trust’s principal purpose, which is,
“the provision of goods and services for the purposes of the health service of England”,
and that is the standard by which it should be held. He is right that waiting lists have been growing. The NHS is doing more than ever—2 million more operations in 2017-18 than in 2010—but we realise that we need to do more, which is why the Prime Minister made the historic commitment to increase funding in the NHS by £20 billion in real terms in five years’ time.
My Lords, is it not the case that people who can afford to see a consultant can jump the queue? In a civilised society, is that not wrong?
The noble Lord well knows that we live in a society which has a mixture of public and private provision. That is true of every public service in most countries of the developed world. The critical point is that we need to invest in our National Health Service, and that is something the Prime Minister is determined to do.
(6 years, 2 months ago)
Lords ChamberThe noble Baroness is quite right that there is an obligation in the GP contract. We are in the process of renegotiating the contract for the next financial year, and I shall certainly take that issue back and feed it in to the team that is carrying out the negotiation.
My Lords, now that austerity is over, when will local government budgets be restored so that local authorities can address issues such as the one we are hearing about today?
Local authority budgets will of course be a matter for the spending review that will take place at some point during the next year.
(6 years, 5 months ago)
Lords ChamberThe noble Lord is right to highlight this issue. It is important to state that the rising cost of indemnity is not driven by a poor or worsening safety record but by the volume of activity and the rising cost of the average claim. Not only do we need to make sure that we reduce those costs, for example, by introducing a fixed recoverable cost scheme, we also need to reduce the number of safety issues so that there are fewer claims to bring in the first place.
My Lords, is it not the case that the costs are rising because GPs do not have sufficient time to see their patients? It is all linked to the shortage of GPs, which means that they have to see more patients for shorter periods.
(6 years, 9 months ago)
Lords ChamberI would definitely be straying into Home Office territory by commenting on that. I would point out that cannabis remains illegal in this country and that the PHE review’s scope is to work within the drug strategy set out by the Home Office.
My Lords, does the shortage of mental health services in the NHS and the cuts to local authorities not mean that GPs often have no alternative but to prescribe drugs? Should the Government not address the shortages in both those areas?
(6 years, 9 months ago)
Lords ChamberI thank my noble friend for that and applaud the work that she has done in this area. The Amsterdam effect seems significant and is an area we are looking at as we consider further actions in future.
Does the Minister agree that it would be a good idea to reintroduce domestic science into all schools so that people have a better mechanism for preparing and eating more quality foods than fast foods?
I reassure the noble Lord that the national curriculum, through PSHE, includes elements around nutrition and healthy eating. Indeed, many schools offer the kind of classes he is talking about.
(6 years, 11 months ago)
Lords ChamberIn the last few years there has been an increase in agency spend. Of course, per nursing hour that tends to be more expensive. We have managed to reduce agency spend by increasing the availability of nursing banks. Those are the people employed on flexible contracts, which is very welcome for many nurses who are looking for—as they say in staff surveys—greater flexible working arrangements.
My Lords, how did the Government get their planning so wrong? The demographics were known, and yet the Government have failed to plan to provide the sorts of numbers of nurses that we need. What went wrong?
We know that we have a growing ageing population—I do not doubt that. We have been increasing real-terms funding for the NHS, which is going on more staff. Nurse numbers have increased and I should point out that there are more doctors and ambulance staff. There have been about 40,000 more clinical staff in general in the NHS over the past few years and more to come in the future.
(7 years ago)
Lords ChamberMy Lords, given the shortage of medical staff right across the board, should not the Government exempt them from quotas so that we can guarantee that we will have the medical staff and support staff that we need in our hospitals?
In the long run, we want to be in a position to provide more of our staff domestically. There are concerns about the fact that we recruit from other countries, not least developing countries—I do not think that that is a long-term, sustainable position. In addition to the additional nurse training places that I mentioned, more medical training places for doctors are coming through, so we will be achieving that position in future.
(7 years ago)
Lords ChamberThe right reverend Prelate is quite right: there is stigma attached. There have been a number of important initiatives, not least from His Royal Highness Prince Harry—who I am sure we all want to congratulate on his recent engagement—to reduce stigma and to demonstrate that mental health problems can, unfortunately, strike anyone of any positional station in society at any time in their life. Making that admission is the first step to seeking help.
My Lords, what are the Government doing to make sure that health trusts spend the resources available on this area of work? The facilities that these children are being seen in is appalling in some cases. What are the Government going to do about both of those issues?
I can reassure the noble Lord that spending on children and young people’s mental health by CCGs, which are responsible for commissioning those services, increased by 20% between 2014-15 and 2015-16, so spending is increasing. Clearly, one of the areas in which that money is being spent is on better facilities. One of the additional changes is that about 150 new beds will be commissioned in underserved areas so that we can reduce the number of out-of-area placements, which can be quite disturbing for some of the children and young people who have to use them.
(7 years, 9 months ago)
Lords ChamberThe noble Baroness is quite right that there is a growing need for care for older people because of our ageing and growing population. I am sure she welcomes the additional funding announced in the Budget. It brings to over £9 billion the additional funding announced since 2015 for social care for the next three years, and that will make a big difference to meeting the kinds of care needs that she is talking about. She talked about the difference between the short term and the long term. That is why the other crucial part of the Budget announcement concerned the Green Paper. This will be ambitious in scope, with the intention of creating a fairer and more sustainable system of the kind I am sure she wants to see.
My Lords, does the Minister agree that the Government’s decision to cut spending to local authorities’ care services has created this crisis?
Much more funding is now going into the social care system to reflect the additional needs of the ageing population. I am looking forwards in thinking about the extra £9 billion that will be provided. We also have over 150,000 more care workers helping people in the system, whether in residential care homes and nursing homes or at home through domiciliary care.
(7 years, 11 months ago)
Lords ChamberI could not agree more with those points, in the sense that money must get through to the front line. However, we have an NHS that is set up so that clinical decisions are made by clinicians rather than politicians, and that must be right, because the needs vary from area to area and different areas have different priorities. They have different historic legacies in terms of delivering their services. As for the direction that we give to schools and colleges, clearly the thematic review that the CQC and Ofsted are carrying out will provide advice on what works. We are also introducing some randomised control trials to look at interventions that work, so we have a proper evidence-based system. The commitment is to get 70,000 more young people having evidence-based treatments by 2021.
My Lords, is it not clear that the present system of “hands off” is not working? People working in this service are desperate to make sure that the Government take action to ring-fence this funding so that vulnerable children are not put at risk.